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Articles 151 - 156 of 156
Full-Text Articles in Bioethics and Medical Ethics
Homocysteine Levels In Preterm Infants: Is There An Association With Intraventricular Hemorrhage? A Prospective Cohort Study., Wendy J Sturtz, Kathleen H Leef, Amy B Mackley, Shailja Sharma, Teodoro Bottiglieri, David A Paul
Homocysteine Levels In Preterm Infants: Is There An Association With Intraventricular Hemorrhage? A Prospective Cohort Study., Wendy J Sturtz, Kathleen H Leef, Amy B Mackley, Shailja Sharma, Teodoro Bottiglieri, David A Paul
Department of Pediatrics Faculty Papers
BACKGROUND: The purpose of this study was to characterize total homocysteine (tHcy) levels at birth in preterm and term infants and identify associations with intraventricular hemorrhage (IVH) and other neonatal outcomes such as mortality, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and thrombocytopenia. METHODS: 123 infants < 32 weeks gestation admitted to our Level III nursery were enrolled. A group of 25 term infants were enrolled for comparison. Two blood spots collected on filter paper with admission blood drawing were analyzed by a high performance liquid chromatography (HPLC) method. Statistical analysis included ANOVA, Spearman's Rank Order Correlation and Mann-Whitney U test. RESULTS: The median tHcy was 2.75 micromol/L with an interquartile range of 1.34 - 4.96 micromol/L. There was no difference between preterm and term tHcy (median 2.76, IQR 1.25 - 4.8 micromol/L vs median 2.54, IQR 1.55 - 7.85 micromol/L, p = 0.07). There was no statistically significant difference in tHcy in 31 preterm infants with IVH compared to infants without IVH (median 1.96, IQR 1.09 - 4.35 micromol/L vs median 2.96, IQR 1.51 - 4.84 micromol/L, p = 0.43). There was also no statistically significant difference in tHcy in 7 infants with periventricular leukomalacia (PVL) compared to infants without PVL (median 1.55, IQR 0.25 - 3.45 micromol/L vs median 2.85, IQR 1.34 - 4.82 micromol/L, p = 0.07). Male infants had lower tHcy compared to female; prenatal steroids were associated with a higher tHcy. CONCLUSION: In our population of preterm infants, there is no association between IVH and tHcy. Male gender, prenatal steroids and preeclampsia were associated with differences in tHcy levels.
Ochrobactrum Anthropi Bacteremia In A Child., Joel D. Klein, Stephen C. Eppes
Ochrobactrum Anthropi Bacteremia In A Child., Joel D. Klein, Stephen C. Eppes
Department of Pediatrics Faculty Papers
Children undergoing chemotherapy for cancer are at increased risk of supervening infection, including bacteremia. This may be due to immunosuppression as well as the presence of intravascular devices such as central venous catheters. Bacteria responsible for these infections include those found in the child's endogenous flora as well as in environmental sources. We report the case of a child with acute lymphoblastic leukemia (ALL) who developed bacteremia secondary to Ochrobactrum anthropi. Details of this extremely rare infection are the focus of this report.
Childhood Typhoid Fever Diagnosed In An Urban U.S. Setting., Surinder K. Sodhi, Stephen C. Eppes, Joel D. Klein
Childhood Typhoid Fever Diagnosed In An Urban U.S. Setting., Surinder K. Sodhi, Stephen C. Eppes, Joel D. Klein
Department of Pediatrics Faculty Papers
The majority of cases of childhood typhoid fever diagnosed in the United States occur in persons recently returned from travel abroad. We report two childhood cases of typhoid fever acquired in Mexico and India and diagnosed in an urban United States setting. This report describes these cases and provides insights into the pitfalls in recognizing this condition in a nonendemic setting as well as information concerning differential diagnosis and treatment.
Malignant External Otitis And Mastoiditis Associated With An Igg4 Subclass Deficiency In A Child., Ricardo Castro, Md, Norman Robinson, Md, Joel Klein, Md, William Geimeier, Md
Malignant External Otitis And Mastoiditis Associated With An Igg4 Subclass Deficiency In A Child., Ricardo Castro, Md, Norman Robinson, Md, Joel Klein, Md, William Geimeier, Md
Department of Pediatrics Faculty Papers
We have presented the first child in Delaware with malignant external otitis associated with IgG4 deficiency. Our patient needed three courses of intravenous antibiotics and twice required mastoidectomy, but has recovered completely following the restoration of the natural barrier between the internal and external ear, using a fascial graft from the large temporalis muscle. Some hearing deficit remains.
Recurrent/Persistent Pneumonia In A 3 1/2-Year-Old-Girl Due To Acquired Immune Deficiency Syndrome., Ricardo Castro, Md, Joel Klein, Md, Rajeswary Padmalingam, Md, Stephen C. Eppes, Md
Recurrent/Persistent Pneumonia In A 3 1/2-Year-Old-Girl Due To Acquired Immune Deficiency Syndrome., Ricardo Castro, Md, Joel Klein, Md, Rajeswary Padmalingam, Md, Stephen C. Eppes, Md
Department of Pediatrics Faculty Papers
The following is the report of the first case of a Delaware born child who developed AIDS, born from a mother who was not in a high risk camp.
Animal Bite Infections., Joel D. Klein, Md
Animal Bite Infections., Joel D. Klein, Md
Department of Pediatrics Faculty Papers
Animal bites have become alarmingly common and may represent a quiet epidemic. It is estimated that between 1 and 3.5 million animal bites occur annually in the United States. The highest incidence has consistently been in 5-to-14-year-old schoolchildren, who have greater contact with animals, especially house pets, on a daily basis. This article discusses the epidemiology, microbiology, clinical findings and management of animal bites infections.